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. 2014 Nov 14;29(6):364–371. doi: 10.1007/s12250-014-3507-x

Viral respiratory infections among Hajj pilgrims in 2013

Osamah Barasheed 1,✉, Harunor Rashid 1, Mohammad Alfelali 1,2, Mohamed Tashani 1, Mohammad Azeem 1, Hamid Bokhary 3, Nadeen Kalantan 4, Jamil Samkari 2, Leon Heron 1, Jen Kok 5, Janette Taylor 5, Haitham El Bashir 6, Ziad A Memish 7, Elizabeth Haworth 8, Edward C Holmes 9,10, Dominic E Dwyer 5,9, Atif Asghar 3, Robert Booy 1,9,10; Hajj Research Team
PMCID: PMC7090649  PMID: 25413828

Abstract

Middle East respiratory syndrome coronavirus (MERS-CoV) has emerged in the Arabian Gulf region, with its epicentre in Saudi Arabia, the host of the ‘Hajj’ which is the world’s the largest mass gathering. Transmission of MERS-CoV at such an event could lead to its rapid worldwide dissemination. Therefore, we studied the frequency of viruses causing influenza-like illnesses (ILI) among participants in a randomised controlled trial at the Hajj 2013. We recruited 1038 pilgrims from Saudi Arabia, Australia and Qatar during the first day of Hajj and followed them closely for four days. A nasal swab was collected from each pilgrim who developed ILI. Respiratory viruses were detected using multiplex RT-PCR. ILI occurred in 112/1038 (11%) pilgrims. Their mean age was 35 years, 49 (44%) were male and 35 (31%) had received the influenza vaccine pre-Hajj. Forty two (38%) pilgrims had laboratory-confirmed viral infections; 28 (25%) rhinovirus, 5 (4%) influenza A, 2 (2%) adenovirus, 2 (2%) human coronavirus OC43/229E, 2 (2%) parainfluenza virus 3, 1 (1%) parainfluenza virus 1, and 2 (2%) dual infections. No MERS-CoV was detected in any sample. Rhinovirus was the commonest cause of ILI among Hajj pilgrims in 2013. Infection control and appropriate vaccination are necessary to prevent transmission of respiratory viruses at Hajj and other mass gatherings.

Keywords: Hajj, influenza-like illness, mass gathering, MERS-CoV, pilgrim, respiratory infections

Footnotes

Hajj Research Team: [Ibtihal Malawi, Ebtehal Matar, Abrar Tawakoul, Abrar ALnami, Atheer Alshareif, Israa Kalantan, Asal Arbaeen, Eatimad Alalawi, Afnan AlGhamdi, Amani Koshak, Ameerah Alkhaldi, Enasm Al-Nami, Anwar Howsawi, Bashaier Fairaq, Bushra Maghrabi, Tafaol Murad, Hanan Alzahrani, Kholood Almehmadi, Doaa Milibari, Rehab Hafiz, Rawdhah Kalantan, Shahad Al-Ansari, Aeshah Rajab, Anood Alfahmy, Ghaida Ali, Fatimah Abu naji, Lujin Hassan, Lulwah Althumali, Layla Farhat, Najlaa Baddour, Hibh Alandanusi, Waad Alqurashi, Sumayyah Fallata, Azhar Alharbi, Joud Bahakeem, Abrar Alshareef, Badr Rawa, Daniah Alnemari, Mawadah Hariri, Samah Alhadramy, Ahmed Alghamdi, Ahmed Muqadimi, Ahmad Bimah, Osama Alamri, Jehad Qutub, Abdulrahman Al-Ghamdi, Abdurrahman Mirza, Abdulghafur Alandijani, Omar Qoqandi, Faisal Mandourah, Muhammad Alghamdi, Mohammed Mahboob, Mohannad Alsulami, Moayyd Hinnawi, Naif Hawsawi, Mousab Alsudais, Nawaf Dhabab, Ahmed Balamash, Mohammed Bawazir, Raif Nassir, Mohammed AlAsmari, Faisal Alzahrani, Abdulrahman Alomari and Ahmad Makeen]

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